Cefotetan and Breastfeeding

Summary of use during lactation

Cefotetan is no longer marketed in the United States. A moderate amount of information indicates that cefotetan produces low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush have been reported with cephalosporins, but these effects have not been adequately evaluated. Cefotetan is acceptable in nursing mothers.

Drug levels in milk and infant serum

Maternal Levels. After a single 1 gram dose of cefotetan to 7 women, the drug was not detected (<0.195 mg/L) in milk in 2 women at any time up to 6 hours after the dose. In the remaining 5 women, average milk levels ranged from 0.22 to 0.34 mg/L from 1 to 6 hours after the dose. The average peak level was 0.34 mg/L 4 hours after the dose, although individual peak levels ranged from 0.25 to 0.5 mg/L at 3 to 4 hours after the dose.[1] Five women were given 1 gram of cefotetan every 12 hours intramuscularly for 2 days. Milk cefotetan levels were undetectable 1 hour after the first dose. From 4 to 10 hours, milk levels ranged from 0.3 to 0.59 mg/L, with the peak occurring 7 hours after the dose. Ten hours after the second, third and fifth doses, milk levels ranged from 0.29 to 0.37 mg/L.[2] After a single 1 gram dose of cefotetan in 2 women, average cefotetan concentrations of 0.1 and 0.2 mg/L occurred at 2 and 4 hours after the dose, respectively. It was undetectable at 1 and 6 hours after the dose.[3] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Relevant published information was not found as of the revision date.

Effects on lactation and breastmilk

Relevant published information was not found as of the revision date.

Alternative drugs to consider

Cefoxitin

References

1. Cho N, Fukunaga K, Kuni K. Fundamental and clinical studies on cefotetan (YM09330) in the field of obstetrics and gynecology. Chemotherapy (Tokyo) 1982;30 (Suppl 1):832-42.
2. Novelli A, Mazzei T, Ciuffi M, et al. The penetration of intramuscular cefotetan disodium into human extra-vascular fluid and maternal milk secretion. Chemotherapy 1983;2:337-42.
3. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol 1984;5:57-60.6743732 PubMed